Management of chronic diabetic foot ulcers using platelet-rich plasma

Babaei, Vahid; Afradi, H; Gohardani, H Z; Nasseri, Farbod; Azarafza, Maryam; Teimourian, Shahram

doi:10.12968/jowc.2017.26.12.784

Cited by 68 publications

(54 citation statements)

References 11 publications

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“…It is acknowledged that the role of platelets at the wound site can be twofold: platelets form an aggregate at the wound site and trigger the inflammatory phase of wound healing,31 but platelets may also be key in the later stages of wound healing by modulating PBMC release of cytokines and growth factors 21. The use of PRP has been successful in a number of clinical settings, particularly in chronic conditions that are characterised by persistently dysregulated inflammation 32, 33. We can hypothesise that a mechanism to promote good healing with PRP may be the ability of platelets to interact with resident leucocytes and dampen down their inflammatory responses at the wound site.…”

Section: Discussionmentioning

confidence: 99%

“…21 The use of PRP has been successful in a number of clinical settings, particularly in chronic conditions that are characterised by persistently dysregulated inflammation. 32,33 We can hypothesise that a mechanism to promote good healing with PRP may be the ability of platelets to interact with resident leucocytes and dampen down their inflammatory responses at the wound site. Nami et al 21 similarly conclude that platelets participate in many, including late, stages of wound healing and this is a previously unappreciated role for this cell type.…”

Section: Discussionmentioning

confidence: 99%

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Platelets regulate leucocyte responses to Toll‐like receptor stimulation

et al. 2018

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ObjectivesPlatelets are important regulators of vascular thrombosis and inflammation and are known to express Toll‐like receptors (TLRs). Through TLRs, platelets mediate a number of responses by interacting with leucocytes. Here, we report the extent to which platelets modulate in vitro peripheral blood mononuclear cells (PBMCs) and granulocyte responses to TLR4, TLR2/1 and TLR2/6 stimulation in healthy subjects.MethodsPeripheral blood mononuclear cells and granulocytes from 10 healthy volunteers were cultured alone or cocultured with platelets. Cultures were left unstimulated or stimulated with 1 or 100 ng mL−1 of either LPS (TLR4 agonist), Pam3CSK4 (TLR2/1 agonist) or fibroblast‐stimulating lipopeptide (FSL)‐1 (TLR2/6 agonist). Neutrophil activation (CD66b expression), monocyte activation (HLA‐DR), granulocyte elastase production and PBMC cytokine and chemokine production were examined.ResultsPlatelet coculture decreased neutrophil CD66b expression in response to LPS, Pam3CSK4 and FSL‐1, and modestly decreased monocyte HLA‐DR expression in response to low‐dose LPS. Platelets reduced granulocyte elastase secretion in response to low doses of all TLR agonists tested. In response to LPS, platelet coculture reduced IL‐6, tumor necrosis factor (TNF)‐α and MIP‐1β production, and increased IL‐10 production by PBMCs. In response to FSL‐1, platelets increased IL‐6, IL‐10 and MIP‐1β production, but reduced TNF‐α production. Platelet coculture did not alter PBMC cytokine/chemokine production in response to Pam3CSK4.ConclusionThis study challenges the notion that platelets act solely in a pro‐inflammatory manner. Rather, platelets are complex immunomodulators that regulate leucocyte responses to TLR stimulation in a TLR agonist‐specific manner. Platelets may modulate leucocyte responses to dampen inflammation, and this platelet effect may play an important role in reducing inflammation‐mediated host damage.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Platelets regulate leucocyte responses to Toll‐like receptor stimulation

et al. 2018

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“…Lesions may lead to lower limb infection, ulcer formation and the destruction of deep tissue (2). Diabetic foot wounds are prone to relapse and wound healing is extremely slow; as such, clinical treatments typically have poor outcomes, which may cause long-term physical and mental suffering and financial hardship for the patient (3).…”

Section: Introductionmentioning

confidence: 99%

Experimental study of epidermal growth factor and acidic fibroblast growth factor in the treatment of diabetic foot wounds

Min

Guo

et al. 2018

Exp Ther Med

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“…A study on the treatment of neuropathic DFUs was conducted in Iran, using the PRP Secollow Kit SK50-20. This study observed a decrease in the ulcers in all groups after seven weeks, with total healing observed after eight weeks, and, upon monitoring the patients afterward, no recurrence was observed [86]. Another report mentioned a clinical case of a 71-year-old type II diabetes patient who suffered severe injuries in his feet due to his inability to feel high temperatures.…”

Section: Platelet-rich Plasma (Prp)mentioning

confidence: 55%

Diabetic Foot Ulcers: Current Advances in Antimicrobial Therapies and Emerging Treatments

et al. 2019

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Diabetic foot ulcers (DFUs) are very important diabetes-related lesions that can lead to serious physical consequences like amputations of limbs and equally severe social, psychological, and economic outcomes. It is reported that up to 25% of patients with diabetes develop a DFU in their lifetime, and more than half of them become infected. Therefore, it is essential to manage infection and ulcer recovery to prevent negatives outcomes. The available information plays a significant role in keeping both physicians and patients aware of the emerging therapies against DFUs. The purpose of this review is to compile the currently available approaches in the managing and treatment of DFUs, including molecular and regenerative medicine, antimicrobial and energy-based therapies, and the use of plant extracts, antimicrobial peptides, growth factors, ozone, devices, and nano-medicine, to offer an overview of the assessment of this condition.2 of 32 history [2]. DFUs are one of the most severe complications of diabetes, and more than half of those ulcers become infected. Every single one of these infected lesions has the potential to get worse and compromise the integrity of the lower limbs. To avoid amputations and improve the patient's quality of life, it is very important to implement a strict program for the prevention and treatment of ulcers, as well as proper management of infections [3]. Thus, it is critical to keep diabetes patients aware of new therapies and treatments and their availability in the healthcare system. The treatment of DFUs requires a multidisciplinary approach with proper medical tools, skills, and knowledge. This starts from patient education, with the application of new classifications to guide the treatment to prevent amputations. New diagnosis methods should become available, such as the 16S ribosomal DNA sequence in bacteria, to provide a better understanding of the microbiota in DFUs. It is reported that DFU has a polymicrobial nature, and, according to its geographical location, certain marked differences, wound characteristics, antibiograms according to local epidemiology, individualized antimicrobial guided therapy, regular debridement, regular assessment of wounds, and change of dressings. The latter characteristics are also aided by new biological and molecular therapies that were proven to improve infection control, the regulation of the local inflammatory profile, and improved quality of the cicatrizing process. In the next sections, this review presents an approach for the diagnosis and treatment of DFUs, focusing on the current advances in antimicrobial therapies, such as dressings,

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Management of chronic diabetic foot ulcers using platelet-rich plasma

Abstract: This study will provide more evidence for the use of autologous PRP for DFUs in patients.

Cited by 68 publications

References 11 publications

Platelets regulate leucocyte responses to Toll‐like receptor stimulation

Platelets regulate leucocyte responses to Toll‐like receptor stimulation

Experimental study of epidermal growth factor and acidic fibroblast growth factor in the treatment of diabetic foot wounds

Diabetic Foot Ulcers: Current Advances in Antimicrobial Therapies and Emerging Treatments

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